Only 7% of ischemic stroke events in the US receive thrombolysis (t-PA) therapy due to delayed hospital arrival, most often related to the failure to recognize stroke symptoms and to call 911 immediately. If the current 7% rate of all ischemic stroke patients receiving tissue plasminogen activator (t-PA) is increased to only 10%, the realized annual cost savings to taxpayers would be more than $45m. Moreover, it has been estimated that interventions designed to educate patients to seek immediate treatment when a stroke occurs may increase thrombolysis rates to 57%, if emergency medical system response times and in-hospital response times are optimized. The goals of this project are to disseminate a novel, evidence-based stroke preparedness (ability to recognize stroke symptoms and call 911 immediately) behavioral intervention to increase ambulance use for stroke, and to identify contextual influences, including barriers and facilitators that affect adoption, implementation, fidelity and maintenance. The program is being disseminated under the auspices of the New York State (NYS) Department of Health Stroke Center designation program to 47 NYS designated stroke centers for implementation in their local catchment area schools. We will use a Hybrid Effectiveness-Implementation Type 3 design that will be informed by the Consolidated Framework for Implementation Research (CFIR). Stroke Centers will serve as hubs for disseminating and implementing our intervention in their local schools. Our intervention, which we have named Hip Hop Stroke, is a novel school- based, multimedia program targeting 4th through 5th graders that uses a framework of Child-Mediated Health Communication to make children stroke literate and then empower these stroke literate students with the tools required to successfully communicate actionable stroke knowledge (recognition of stroke symptoms and the urgency of calling 911) to their parents and grandparents at home. The effectiveness of Hip Hop Stroke has been established in a recently completed NIH funded study, and our intervention has been cited in major stroke prevention guideline articles. Hip Hop Stroke is well known within the NYS stroke community, has shown high acceptability among NYS schools and, most importantly, helps Stroke Centers fulfill their annual regulatory community stroke education mandates.
Using a Hybrid-Effectiveness Implementation Type 3 design, and guided by Consolidated Framework for Implementation Research, we aim to disseminate a novel, evidence-based stroke preparedness behavioral intervention to a heterogeneous (urban, suburban, and rural) population via 47 NYS Stroke Centers, through a partnership with the New York State Department of Health (NYSDOH) Stroke Designation Program. New York State has one of the largest state-based stroke systems of care in the United States. Therefore, accomplishing these aims may represent - for the first time - an important step toward standardizing public stroke education efforts across an entire stroke system of care, and serve as a model for a more systematic sustainable approach to hospital based public stroke education efforts.
| Williams, Olajide; Leighton-Herrmann Quinn, Ellyn; Teresi, Jeanne et al. (2018) Improving Community Stroke Preparedness in the HHS (Hip-Hop Stroke) Randomized Clinical Trial. Stroke 49:972-979 |
| Simmons, Cailey; Noble, James M; Leighton-Herrmann, Ellyn et al. (2017) Community-Level Measures of Stroke Knowledge among Children: Findings from Hip Hop Stroke. J Stroke Cerebrovasc Dis 26:139-142 |
| Noble, James M; Hedmann, Monique G; Williams, Olajide (2015) Improving dementia health literacy using the FLOW mnemonic: pilot findings from the Old SCHOOL hip-hop program. Health Educ Behav 42:73-83 |
| Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra et al. (2015) Hip Hop Stroke: Study Protocol for a Randomized Controlled Trial to Address Stroke Literacy. J Clin Trials 5: |
| Gutierrez, Jose; Williams, Olajide A (2014) A decade of racial and ethnic stroke disparities in the United States. Neurology 82:1080-2 |
| Williams, Olajide; Hecht, Mindy F; DeSorbo, Alexandra L et al. (2014) Effect of a novel video game on stroke knowledge of 9- to 10-year-old, low-income children. Stroke 45:889-92 |
| DeSorbo, Alexandra L; Noble, James M; Shaffer, Michele et al. (2013) The use of an audience response system in an elementary school-based health education program. Health Educ Behav 40:531-5 |
| Williams, Olajide; DeSorbo, Alexandra; Noble, James et al. (2012) Child-Mediated Stroke Communication: findings from Hip Hop Stroke. Stroke 43:163-9 |
| Williams, Olajide; DeSorbo, Alexandra; Noble, James et al. (2012) Long-term learning of stroke knowledge among children in a high-risk community. Neurology 79:802-6 |
